Hemperly Stephen E, Agarwal Niti Sardana, Xu Ying-Yang, Zhi Yu-Xiang, Craig Timothy J
Department of Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA.
J Am Osteopath Assoc. 2013 Jul;113(7):546-55. doi: 10.7556/jaoa.2013.006.
Hereditary angioedema (HAE) is a rare genetic condition that manifests as painful and potentially life-threatening episodic attacks of cutaneous and submucosal swelling. It results from functional deficiency of C1 inhibitor (C1 INH), which is a regulator of the complement, fibrinolytic, kinin (contact), and coagulation systems. In patients with HAE, the low plasma concentration of functional C1 INH leads to overactivation of the kinin cascade and local release of bradykinin. Bradykinin is responsible for the pain, vascular permeability changes, and edema associated with HAE. Until recently, therapeutic options for HAE have been very limited. Many new therapies have emerged, however, such as C1 INH replacement drugs and medications aimed at components of the contact system (eg, plasma kallikrein inhibitor and bradykinin B2 receptor antagonist). The authors review current and novel treatments for patients with HAE.
遗传性血管性水肿(HAE)是一种罕见的遗传性疾病,表现为皮肤和黏膜下肿胀的疼痛性发作,且可能危及生命。它是由C1抑制剂(C1 INH)功能缺陷引起的,C1 INH是补体、纤维蛋白溶解、激肽(接触)和凝血系统的调节剂。在HAE患者中,功能性C1 INH的血浆浓度低会导致激肽级联反应过度激活和缓激肽局部释放。缓激肽是导致与HAE相关的疼痛、血管通透性改变和水肿的原因。直到最近,HAE的治疗选择一直非常有限。然而,许多新疗法已经出现,例如C1 INH替代药物以及针对接触系统成分的药物(如血浆激肽释放酶抑制剂和缓激肽B2受体拮抗剂)。作者综述了HAE患者的现有治疗方法和新疗法。